胃大部切除术后感染危险因素的分析

目的研究胃大部切除术后感染的危险因素，为预防与控制术后感染提供理论支持。方法回顾性分析本院2004年8月至2008年12月行胃大部切除根治术的71例患者，分析患者的年龄、性别等15项变量与术后感染的关系，用X^2检验和四格表检验作单因素分析，用Logistic回归作多因素分析。结果胃大部切除术后感染率为13．12％，单因素分析发现糖尿病、胃十二指肠溃疡、呼吸系统疾病、发热、术后白细胞、围手术期输血浆等与术后感染有显著的关联（P〈0．05），而年龄、性别、手术时间、手术方式、血红蛋白含量、肿瘤分期（TNM）等与感染的发生无显著关联；多因素分析筛选出6个术后感染的相关因素：胃、十二指肠溃疡、呼吸系统疾病、低体质量、糖尿病、发热、围手术期输血浆，差异有统计学意义（P〈0．05）。结论胃、十二指肠溃疡、呼吸系统疾病、低体质量、糖尿病、发热、围手术期输血浆与胃大部切除术后感染有关，手术前后采取相应的处理措施，可降低术后感染的发生率。

Analysis of risk factors for infection after subtotal distal gastrectomy

Objective To investigate the risk factors of postoperative infections in the patients after subtotal distal gastrectomy,and to provide the theoretical basis of postoperative infection control. Methods Totally 71 patients in our hospital after performing subtotal distal gastreetomy from Aug. 2004 to Dec. 2008 were retrospectively analyzed. Fifteen risk factors （sex,age,ere） were investigated. X^2 test and cross tabulation test were used to process the single factor. Logistic regression analysis was used to process the multivariate factors. Results The postoperative infection rate in subtotal distal gastrectomy was 13.12%. Univariate Logistic regression analysis indicated that 6 variables were significantly related to the likelihood of postoperative infections （P〈0.05） ： diabetes,gastroduodenal ulcer,disease of respiratory system,type of operation, fever,postoperative WBC and perioperative plasma transfusion. However, the postoperative infection rate was not closely related to the patients＇ sex and age, duration of operation, tumors,TNM pathologic stage, etc（P〉0.05）. Multivariate analyses found that 6 variables were related to postoperative infections（P〈0.05） ：gastroduodenal ulcer, disease of respiratory system, type of operation and fever. Conclusion Gastroduodenal ulcer, disease of respiratory system, underweight, diabetes, fever, perioperative plasma transfusion are closely related to postoperative infections in subtotal distal gastrectomy. It can decrease the incidence of postoper ative infections to take relevant prevention measures preoperatively and postoperatively.